Pediatric Drug Doses

PediatricDrug Doses



Pediatric Drug Doses GL Chattri MBBS MD Paediatrician and Neonatologist Consultant Mahakoushal Hospital and Seth Mannul Hospital, Jabalpur 154 Tamarhai Chowk Kotwali Ward Jabalpur, Madhya Pradesh, India ® JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTDNew Delhi • St Louis (USA) • Panama City (Panama) • London (UK) • Ahmedabad Bengaluru • Chennai • Hyderabad • Kochi • Kolkata • Lucknow • Mumbai • Nagpur

Published byJitendar P VijJaypee Brothers Medical Publishers (P) LtdCorporate Office4838/24 Ansari Road, Daryaganj, New Delhi - 110002, India, Phone: +91-11-43574357,Fax: +91-11-43574314Registered OfficeB-3 EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi - 110 002, IndiaPhones: +91-11-23272143, +91-11-23272703, +91-11-23282021+91-11-23245672, Rel: +91-11-32558559, Fax: +91-11-23276490, +91-11-23245683e-mail: [email protected], Website: www.jaypeebrothers.comOffices in India Ahmedabad, Phone: Rel: +91-79-32988717, e-mail: [email protected] Bengaluru, Phone: Rel: +91-80-32714073, e-mail: [email protected] Chennai, Phone: Rel: +91-44-32972089, e-mail: [email protected] Hyderabad, Phone: Rel:+91-40-32940929, e-mail: [email protected] Kochi, Phone: +91-484-2395740, e-mail: [email protected] Kolkata, Phone: +91-33-22276415, e-mail: [email protected] Lucknow, Phone: +91-522-3040554, e-mail: [email protected] Mumbai, Phone: Rel: +91-22-32926896, e-mail: [email protected] Nagpur, Phone: Rel: +91-712-3245220, e-mail: [email protected] Offices North America Office, USA, Ph: 001-636-6279734, e-mail: [email protected], [email protected] Central America Office, Panama City, Panama, Ph: 001-507-317-0160, e-mail: [email protected], Website: www.jphmedical.com Europe Office, UK, Ph: +44 (0) 2031708910, e-mail: [email protected] Drug Doses© 2010, Jaypee Brothers Medical PublishersAll rights reserved. No part of this publication should be reproduced, stored in a retrievalsystem, or transmitted in any form or by any means: electronic, mechanical, photocopying,recording, or otherwise, without the prior written permission of the author and the publisher. This book has been published in good faith that the material provided by author is original. Every effort is made to ensure accuracy of material, but the publisher, printer and author will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only.First Edition: 2010ISBN 978-81-8448-946-0Typeset at JPBMP typesetting unitPrinted at Ajanta Offset and Packagins Ltd., New Delhi

Dedicated In the memory oflate (Prof) Dr VJ Rajpoot Sir (Indore), who taught me the art of pediatrics



PrefaceI am pleased to have the opportunity to write this firstedition of \"Pediatric Drug Doses\". It is not intended tocompete with the already well-established books. This bookis designed to be a practical and convenient guide to thedosing and usage of medications in children. Pediatric doses vary with the age, weight, surface areaand disease, etc. Overdosing may lead to side effects andunder-dosing will lead to unsatisfactory response ordevelopment of resistance in cases of antibiotics. I did not confine myself to doses only, but expended toprovide indications which is a must before knowing doses,and also included the information such as size of feedingtubes, Foley's catheters, endotracheal tubes, laryngoscopeblades, oxygen mask according to age and weight;approximate weight and surface area charts; fluidresuscitation formula for burn patients; so that residentsdo not have to consult too many books while dealing withpatients bedside. The aim is to improve the practical utilityof the book. I have made all efforts to check for any mistakes in thetext and drug doses, but nobody can be perfect. If you arein any doubt about a treatment or drug doses, always checkwith another formulary. Due to constant research, it isadvised to consult package insert especially for infrequentlyused drugs and drugs with narrow therapeutic index. I have written this book for pediatric house officers andregistrars particularly keeping in mind but it will also beuseful for consultant practicing pediatricians. GL Chattri



AcknowledgmentsFirst of all I would like to thank my wife Rashmi and mykids Dhruv and Shlok who spare me to spend, from theirshare of valuable time, in writing this book. She was alwaysencouraging me to make my dream come true. I sincerely thank Mr Bhoopesh Arora, Jaypee BrothersMedical Publishers (P) Ltd, New Delhi and their staff forpublishing this book. I would like to thank Mr Sanjeev Pandey for hisprofessional and personal support. Last but not the least, I would like to thank Dr SharadThora, Dr Hemant Jain, Dr Mahesh Meheswari, Dr SameerAgarwal, Dr Nivedita Kapoor for their guidance andsupport.



Structure of the BookAll the drugs are listed in their respective group and arecovered in short to make the book user friendly. Druginformation is presented in a consistent format and providesthe following.Generic Name: Indian adopted name.Uses: Information pertaining to appropriate indications oruse of the drug.Usual Dosages: The amount of drug to be typically givenor taken during therapy in general and in certain specificconditions. For selected drugs, the dosing adjustment inrenal and/or hepatic impairment should be madeaccordingly.Brand Names: Common trade names available in India.Combinations: If any. So, if one has reached to the final or probable diagnosis,then this book will provide the remaining information –drugs which can be prescribed, dosages, brands and formsavailable, and mode of administration.



Contents 1. Analgesics .................................................................... 1 2. Antiasthmatics .......................................................... 11 3. Antiarrhythmics ....................................................... 17 4. Antibiotics .................................................................. 21 5. Anticoagulants .......................................................... 55 6. Antidepressants ........................................................ 57 7. Antidotes/Poisoning ............................................... 60 8. Antiemetics ................................................................ 66 9. Antiepileptics ............................................................ 7010. Antifungals ................................................................ 8111. Antigout Agents ....................................................... 8612. Anthelmintics ............................................................ 8813. Antihistamines .......................................................... 9314. Antihypertensives .................................................... 9715. Antileprotics ............................................................ 10516. Antimalarials ........................................................... 10617. Antimyasthenics ..................................................... 11118. Antiprotozoals ........................................................ 11319. Antipsychotics/Anxiolytics/Sedatives .............. 11620. Antiretrovirals ......................................................... 11921. Antituberculars ....................................................... 12422. Antispasmodics ....................................................... 12723. Antitoxins ................................................................ 12924. Antiulcers/Antisecretories ................................... 13125. Antivirals ................................................................. 133

xiv Pediatric Drug Doses 26. Cardiac Shocks and Failures ................................. 139 27. Chelating Agents .................................................... 141 28. Colony Stimulating Factors .................................. 143 29. Corticosteroids ........................................................ 145 30. Diuretics ................................................................... 149 31. Drugs Used for Controlling Bleeding ................. 153 32. Electrolyte Supplements and Fluid Replacements ................................................ 155 33. H2 Antagonists ........................................................ 159 34. Immunoglobulins ................................................... 160 35. Laxatives/Stool Softeners ..................................... 164 36. Minerals ................................................................... 166 37. Nutritional Supplements ....................................... 168 38. Pituitary Hormones ................................................ 170 39. Plasma Volume Expanders ................................... 172 40. Scabicidal Agents .................................................... 174 41. Skeletal Muscle Relaxants ..................................... 175 42. Sympathomimetics ................................................. 177 43. Thyroid and Antithyroid Agents ......................... 180 44. Vaccines .................................................................... 182 45. Vasodilators ............................................................. 187 46. Vitamins ................................................................... 188 47. Miscellaneous .......................................................... 193 Index .......................................................................... 209

Symbols and AbbreviationsADHD Attention Deficit Hyperactivity DisorderAEDs Anti Epileptic DrugsAIDS Acquired Immuno Deficiency SyndromeAOM Acute Otitis MediaAPTT Activated Partial Thromboplastin TimeBA Bronchial AsthmaBD Twice a dayCHF Congestive Heart FailureCMV CytomegalovirusCNS Central Nervous SystemCSF Cerebrospinal FluidDCL Diffuse Cutaneous LeishmaniasisDM Diabetes MellitusDIC Disseminated Intravascular CoagulationET Endotracheal TubeE/E Eye/Earg GramG6PD Glucose-6-Phosphate DehydrogenaseGERD Gastroesophageal Reflux DiseaseGI Gastrointestinalh/hr HourHSV Herpes Simplex VirusHT HypertensionICP Intracranial Pressure

xvi Pediatric Drug DosesID IntradermalIgG Immunoglobulin-GIM IntramuscularITP Idiopathic Thrombocytopenic PurpuraIV IntravenousIVH Intraventricular HemorrhageIVP Intravenous PushJRA Juvenile Rheumatoid ArthritisKg KilogramLAB Lactic Acid BacillusLCL Localized Cutaneous LeishmaniasisLMWH Low Molecular Weight HeparinLRTI Lower Respiratory Tract Infectionmcg MicrogramMg MilligramMin MinuteML Milliliter / Mucosal LeishmaniasisNB NewbornNG NasogastricNS Normal SalineNSAID Non-steroidal Anti-inflammatory DrugOD Once a dayOM Otitis MediaPCM ParacetamolPDA Patent Ductus ArteriosusPNA Postnatal AgePO Per OralPSVT Paroxysmal Supraventricular Tachycardia

QID Symbols and Abbreviations xviiRDARTI Four times per daySC Recommended Daily AllowanceSL Respiratory Tract InfectionSLE SubcutaneousSSTI SublingualTB Systemic Lupus ErythematosusTDS Skin and Soft Tissue InfectionTPN TuberculosisURTI Thrice a dayUTI Total Parenteral NutritionVL Upper Respiratory Tract InfectionVZV Urinary Tract Infection< Visceral Leishmaniasis> Varicella Zoster Virus< Less than> Greater than Less than or equal to Greater than or equal to

1 AnalgesicsANALGESIC—NON-NARCOTIC1. Acetylsalicylic acidUse: Treatment of inflammation, fever and mild to moderatepainDosage: PO• Pain and fever: 10-15 mg/kg/dose q 4 - 6 h.• Anti-inflammatory: 60-90 mg/kg/ day in divided doses.• Anti-platelet effect: 3-10 mg/kg/day, single daily dose.• Kawasaki disease: 80-100 mg/kg/day divided q 6 h.• Rheumatic fever: 60-100 mg/kg/ day divided q 6 h.Brands: Ecosprin Tab; 75, 150 and 325 mg. Delisprin Tab;75 and 150 mg. Zosprin Tab; 100 and 150 mg.• Contraindicated in Chicken Pox or if there is flu-like symptoms, hepatic failure, bleeding disorder, erosive gastritis, peptic ulcer, bronchial asthma. Discontinue the drug if hearing loss or tinnitus occurs.2. AuranofinUse: Management of active stage of classic or definiterheumatoid, psoriatic arthritis.Dosage: PO. Starting 0.1 mg/kg/day in 2 divided doses.Maintenance: 0.15 mg/kg/day. (Max: 0.2 mg/kg/day)

2 Pediatric Drug DosesBrand: Cap. Ridaura 3 mg, Tab. Goldar 3 mg.• Contraindicated in blood dyscrasias, CHF, NEC, SLE, leucopenia, urticaria etc. Stop therapy if platelet count < 100,000/mm3, WBC < 4,000/mm3.3. Diclofenac SodiumUse: Mild to moderate pain, juvenile rheumatoid arthritis.Dosage: PO. 2-3 mg/kg/day divided q 4 h.Brands: 50 and 100 mg Tab; Agile, Diclofam, Diclomax.• Also available in topical formulation as gel; Diclonac, Nac, Voveran 1% gel; transdermal patch, Nupatch. Contraindicated in GI bleeding, ulcer disease, aspirin triad. Use with caution in HT, BA, CHF, fluid retention, dehydration etc.4. IbuprofenUse: Fever, pain, JRA, cystic fibrosis, PDA.Dosage: PO• Fever, Pain: 4-10 mg/kg/dose q 6-8 hr (Max: 40 mg/ kg/day)• JRA: 30-50 mg/kg/day in 4 divided doses (Max: 2.4 gm/ day)• Cystic Fibrosis: 20-30 mg/kg twice daily for 4 yrs• PDA: IV: Initial dose of 10 mg/kg, followed at 24 hour intervals by two doses of 5 mg/kg.Brands: 100 mg/5 ml Susp; Bren, Ibugesic, Febrilix. 200 and400 mg. Tab; Brufen, Emflam, Ibugesic, Ibugin.Combinations: Ibuprofen + Paracetamol: 400 + 325 mg Tab,100+162.5 mg/5 ml susp; Anaflam, Combiflam, Ibucin.• Contraindicated in GI bleeding, ulcer disease, aspirin triad. Use with caution in CHF, HT, dehydration, hepatic and renal patients.

Analgesic 35. IndomethacinUse: PDA closure in neonates, rheumatoid arthritis,nephrogenic diabetes insipidus.Dosage:• Neonates: PDA: IV; 0.2 mg/kg initially followed by 2 doses at 12-24 hours intervals.• Rheumatoid/Inflammatory disorders: PO; 1-2 mg/kg/ day in 2-4 doses. (Max: 4 mg/kg/day).• Nephrogenic diabetes insipidus: PO; 2 mg/kg/day. (for patients having inadequate response to diuretics alone may benefit from its addition).Brands: 25 and 50 mg Cap; Artisid, Indocap, Microcid etc.• Contraindicated in premature neonates with NEC, impaired renal functions, IVH, bleeding, throm- bocytopenia. It may decrease the antihypertensive effect of diuretics.6. KetorolacUse: Treatment of ocular itch associated with seasonalallergic conjunctivitis.Dosage: Children > 3yrs: 1 drop in eyes 4 times/ day; upto7 days.Brands: 0.5% drop; Acular, Doloket, Ketanav, Ketodrop etc.Administration: Apply pressure over Lacrimal sac for 2minutes after application to avoid absorption and systemiceffects.7. Mefenamic acidUse: Fever, pain, rheumatoid disorders.Dosage: PO. Should not be given for more than 7 days.• Fever: 3mg/kg/dose.• Rheumatoid disorder: 10-25 mg/kg/day q 6 hr.

4 Pediatric Drug DosesBrands: 100, 250 and 500 mg Tab; 100 and 50 mg/5ml susp;Meftal, Ponstan.Combinations:Mefenamic + Paracetamol: 500 + 450 mg Tab - Meftal Forte.Mefenamic + Dicyclomine: 250 + 10 mg Tab- Meftal Spas.8. NaproxenUse: Fever, pain, inflammation and rheumatoid disorders.Dosage: PO. For children > 2 yrs of age.• Pain: 5-7 mg/kg/dose q 8-12 hrs.• JRA/Inflammatory disease: 10-15 mg/kg/day in two divided doses. (Max: 1000 mg/day)Brands: 250 mg Tab; Astagen, Nalyxan, Napryn.9. NimesulideUse: Fever, pain and inflammatory conditions.Dosage: PO. 5 mg/kg/day in 2-3 divided doses.Brands: 50 and 100 mg Tab; 50 mg / 5 ml susp; Emsulide,Neosaid, Nimegesic, Pronim etc.Combinations: Nimesulide + Paracetamol: 100 + 500 mgTab; 50 + 125 mg susp; Sumo, Emsulide - P, Dolomide.10. Paracetamol/AcetaminophenUse: Mild to moderate pain and fever. Do not have an anti-inflammatory or anti-rheumatic effect.Dosage:• Neonates: PO, rectal: 10-15 mg/kg/dose q 6-8hours.• Infants and children: PO: 10-15 mg/kg/dose q 4-6 hr; Rectal: 10-20 mg/kg/dose q 4-6 hrs; IM: 5 mg/kg/dose.Brands: 150 mg/ml drops; 125 mg/5 ml and 250 mg/5 mlsusp; 500 mg Tab; Calpol, Crocin, Febrex, Metacin, Pacimol.

Analgesic 580 and 170 mg. suppository, Anamol. 150 mg/ml Inj.;Fevastin, Febrinil, Mol.• Overdoses of paracetamol can be treated with acetylcysteine.11. PiroxicamUse: Rheumatoid and inflammatory disorders.Dosage: PO. 0.2-0.3 mg/kg/day as single dose (Max: 15 mg/kg/day).Brands: 10 and 20 mg Tab and Cap; Brexic, Minicam,Paricam. Use with caution in infants and children.12. TolmetinUse: Inflammatory and rheumatoid disorders (JRA).Dosage: Children > 2 yrs. of age: PO• Anti-inflammatory: 15-20 mg/kg/day in 3-4 divided doses; (Max: 30 mg/kg/day)• Analgesic: 5-7 mg/kg/dose q 6-8 h.Brands: 200 mg Tab; 400 mg Cap; Tolectin.

6 Pediatric Drug DosesANALGESIC—NARCOTIC1. CodeineUse: Mild to moderate pain; for non-productive cough usein lower doses.Dosage:• Pain: 0.5-1 mg/kg/dose q 4-6 hour (Max: 60 mg/dose).• Cough: 1-1.5 mg/kg/day divided q 4-6 hour (Not recommended in children < 2 yrs of age).Brands: Codine linctus: Codeine sulphate 15 mg + Menthol0.2 mg/5 ml. Phensedyl, Codokuff: Codeine Phosphate10 mg + Chlorpheniramine 4 mg/5 ml. Lincotuss: CodeinePhosphate 15 mg/5 ml.• Increase fluid and fibre intake to avoid constipation.• Contraindicated in pre-existing respiratory illness, asthma and raised ICP. Causes constipation, nausea, anorexia, vomiting, sedation, dizziness.2. FentanylUse: Sedation, pain relief, preoperative medication, adjunctto anesthesia.Dosage:• Neonates and infants: IV: Intermittent doses: 1-4 mcg/ kg/dose; may be repeated q 2-4 h; continuous infusion: 0.5-5 mcg/kg/h.• Older infants and children: 1-12 yrs: Pain: IM, IV: 1-3 mcg/kg/dose; may be repeated after 30 minutes; continuous infusion: 1-5 mcg/kg/h.• Children > 12yrs.: Pain: IM, IV: 0.5-1 mcg/kg/dose; may be repeated after ½ to 1 hour.• Anesthesia: IM, IV: 2-50 mcg/kg.

Analgesic 7Brands: 50 mcg/ml Inj., Fendrop, Fenilate, Fent, Trofentyl.Patch of 25, 50 and 100 mcg/hr, Duragesic.Administration: For IV administer slowly over 5-10minutes. Rapid IV infusion may cause skeletal musclerigidity, impaired ventilation, apnea, laryngospasm.• Contraindicated in raised ICP, severe respiratory depression, hepatic or renal problems. Physical and psychological dependence may occur with prolonged use.3. Morphine SulphateUse: Pain relief; relieves dyspnea of left ventricular failureand pulmonary edema; preanesthetic medication.Dosage:• Neonates: IV, IM, SC: Continuous infusion: 0.01-0.03 mg/ kg/h; Intermittent dose: 0.05 - 0.1 mg/kg/dose q 2-4 h.• Infants and children: IV, IM, SC: 0.1-0.2 mg/kg/dose q 2-4 hrs. (Max: 15 mg/dose); PO: 0.2-0.5 mg/kg/dose q 4-6 hr.• > 12yrs: 3-4 mg; may be repeated after 5 min as required.Brands: 10 and 30 mg Tab; Duramor, Morcontin. 10 mg/mlInj., Morphine Sulphate.Administration: Administer IV over 15-30 min at a finalconcentration of 0.5-5 mg/ml.• Contraindicated in respiratory depression, GI obstruction, acute or severe asthma, liver or renal problems. Neonates and infants < 3 months are more susceptible to respiratory depression.4. PentazocineUse: Relief of moderate to severe pain, sedative prior tosurgery.

8 Pediatric Drug DosesDosage: Efficacy and safety not confirmed below 12 yrsChildren> 12yrs: PO: 50 mg/dose q 3-4h; (Max: 600 mg/day). IV or IM dose is 1/3 of PO dose.Brands: 25 mg Tab; Fortwin. 30 mg/ml Inj; Fortwin,Pentawin, Susevin.Combinations: Pentazocine + PCM: 15 + 500 mg Tab;Expergesic, Fortagesic.5. Pethidine / MeperidineUse: Pain, adjunct to anesthesia and preoperative sedation.Dosage: IV, IM: 1-1.5 mg/kg/dose q 3-4 hr as needed; 1-2mg/kg as preoperative medication single dose (Max: 100mg/dose).Brands: 50mg/ml Inj; Pethidine hydrochloride.Administration: For IV, dilute to 1-10 mg/ml and to begiven over 15-30 minutes.• Use with caution in head injury, raised ICP and in young children. Pethidine though used in combination with chlorpromazine and promethazine in lytic cocktail; this mixture may have a higher rate of adverse effects compared to alternative sedatives and analgesics.

Analgesic 9ANALGESIC—TOPICAL1. BenzocaineUse: Toothache, sore throat pain, hemorrhoids, rectalfissures, minor burns etc.Dosage: Apply to affected area as needed. Mouth/throat,usage should not exceed 2 days.Brand: 7.5% gel, T-JEL.2. LidocaineUse: Local anesthetic, relief of pain in post herpeticneuralgia, ventricular arrhythmias.Dosage:• Topical: Apply as needed but maximum dose is 3 mg / kg /dose; do not repeat within 2 hrs.• Injectable local anesthetic: As needed but maximum dose is 4.5 mg/kg/dose; do not repeat within 2 hrs.• Arrhythmias: Loading dose: 1 mg / kg; Continuous infusion 20-50 mcg / kg / minute ( 20 mcg / kg /minute in patients with shock, mild CHF, liver disease, cardiac arrest).• Post herpetic neuralgia: Apply patch to affected areas (Max: 3 patch).Brands: Gesicain, lignox: 5% Inj., 2% Jelly, 5% Ointment,4% topical solution. Xylocain: 1, 2 and 5% Inj., 2% Jelly, 5%Ointment, Spray, 4% Topical solution, 2% Viscous.Xylocard: 50 ml vial (1ml = 21.3 mg)Administration: For IV, dilution should be 8-20 mg/ml.Lidocaine solutions containing epinephrine should not beused for treatment of arrhythmias and preservativecontaining solutions should not be used for IV.

10 Pediatric Drug DosesANALGESIC—URINARYPhenazopyridineUse: Symptomatic relief of urinary burning, frequency andurgency associated with UTI or urologic procedures.Dosage: PO: 12 mg/kg/day divided q 8hrs.Brands: Pyridium 200 mg Tab.Combinations: Phenazopyridine + Nitrofurantoin: 200 + 50mg Tab, Nephrogesic.• It is not an antibiotic and don't treat infections. May discolor urine to orange or red.

2 Antiasthmatics1. Adrenaline/EpinephrineSee under sympathomimetic.2. AminophyllineUse: As bronchodilator, apnea of prematurity, increasediaphragmatic contractility.Dosage:• Acute bronchospasm: IV; Loading dose of 6 mg/kg diluted to 1 mg/ml and infuse over 30 min followed by 0.5-1 mg/kg/h as continuous infusion, if already on oral therapy, omit loading dose. PO; 15-20 mg/kg/day divided q 8 hrs.• Apnea of prematurity: PO, IV; loading dose of 6 mg/kg followed by maintenance dose of 2.5-3 mg/kg/dose q 12 hrs.Brands: 100 mg tab; 25 mg/ml Inj; Aminophylline.• May cause seizures, tachyarrhythmias, feeding intolerance in neonates, gastroesophageal reflux, vomiting, CNS irritability.3. BeclomethasoneUse: Long term control of asthma.Dosage: Inhalation: 100 to 800 mcg/day in divided dosesdepending on severity.

12 Pediatric Drug DosesBrands: 50, 100, 200 and 250 mcg/actuation; Beclate Inhaler.50, 100, 250 mcg/actuation; Becoride inhaler. 100 and 200mcg rotacap; Beclate, Bevent.Combinations: Beclomethasone+Salbutamol: 50 + 100 mcgInhaler; 100 + 400 mcg Rotacaps; Aerocort, Vent-plus.• To reduce chances of oral candidiasis, rinse mouth after inhalation. Use spacer device for inhalational corticosteroids in children for better lung delivery and less local toxicity.4. BudesonideUse: Allergic rhinitis, long term prophylaxis andmaintenance therapy of asthma.Dosage: 100-200 mcg/day in divided doses depending uponseverity. Nasal spray 2 times/day.Brands: 0.5 and 1mg/2ml respule; Budate, Budecort. 100and 200 mcg/actuation inhaler; Budecort. 100 and 200 mcgrotacaps; Budecort. 50 mcg/dose nasal spray; Pulmicort.• Use with precautions in patient with pulmonary TB, systemic infection and ocular herpes.5. FluticasoneUse: Chronic asthma.Dosage: Depends upon severity and systemiccorticosteroids use. 100-600 mcg/day divided q 12 hrs.Brands: 0.5 mg respule; 25, 50 and 125 mcg/actuationinhaler; 50, 100 and 250 mcg rotacaps; Flohale.• May cause oral candidiasis, change of voice, adrenal suppression, growth retardation, cataracts.

Antiasthmatics 136. FormoterolUse: Treatment and prophylaxis of asthma.Dosage: >5 yr of age: 12 mcg twice daily 12 hrs apart.Brands: 12 mcg rotacaps and inhaler; Foratec.Combination: Formoterol + Budesonide: 6 + 200 mcg and6 + 400 mcg rotacaps and inhaler; Foracort, Vent-FB.7. IpratropiumUse: Acute and chronic asthma.Dosage: Neonates: 25 mcg/kg/dose 3 times/day asnebulization.Infants and Children: 125-250 mcg as nebulization or 1-2puffs 2-3 times/day.Brands: 250 mcg/ml solution for nebulization; Ipramist,Ipravent. 20 mcg/actuation inhaler; 40 mcg rotacaps;Ipravent and Ipratop.• May cause tachycardia, drowsiness, xerostomia, blurred vision.8. MontelukastUse: Prophylaxis and chronic treatment of asthma;symptomatic relief of seasonal allergic rhinitis.Dosage: 1-5years: 4 mg/day; 6-14years: 5 mg/day;>14years: 10 mg/day; given as once evening dose.Brands: 4, 5 and 10 mg tab; Emlucast, Montair, Romilast.4 mg granules; Montair.• May cause palpitations, headache, elevated liver enzymes, myalgia, fatigue.

14 Pediatric Drug Doses9. SalbutamolUse: Prevention and relief of bronchospasm in asthma.Dosage:• Nebulization: Neonates; 0.1-0.5 mg/kg/dose or q 2-6 hours. Children; 0.15-2.5 mg/dose or q 4-6 hours. (Min: 2.5 mg)• Inhaler: 100-800 mcg/day in divided dose.• PO: Neonates: 0.1-0.3 mg/kg/dose q 6-8 hours. Children; < 6years: 0.1-0.2 mg/kg/dose TDS, 6-12 years: 2 mg/ dose TDS or QID, >12 y: 2-4 mg TDS or QID.Brands: 2 and 4 mg Tab; 2 mg/5 ml Syrup; 100 mcg/actuation inhaler; Asthalin, Ventorlin. 2.5 mg/2.5 mlrespule; Asthalin, Derihaler. 200 and 400 mcg rotacaps;Asthalin.Combinations: Salbutamol + beclomethasone: 100 + 50 mcgInhaler; Aerocort, Salbair-B. 200 + 100 mcg rotacaps;Aerocort.• May cause tachycardia, palpitation, hyperglycemia, tremor, CNS stimulation, insomnia, flushing.10. SalmeterolUse: Maintenance treatment of asthma.Dosage: 25-50 mcg twice daily in children > 4 yrs of age.Brands: 25 mcg/actuation inhaler; 50 mcg rotacaps;.Serobid.11. Sodium CromoglycateUse: Prophylaxis for chronic asthma, allergic rhinitis, vernalkeratoconjunctivitis.

Antiasthmatics 15Dosage: Nebulization; 20 mg 2-3 times/day. Inhaler; 1-2puffs 3-4 times/day. Intranasal in > 2 years of age, 1 spray3-4 times/day. Ophthalmic in > 4 years of age: 1-2 drop 3-4times/day.Brands: 5 mg/actuation inhaler; 20 mg/2 ml respule; 20mg rotacaps; 2% eye drop; Cromal. 1 mg/actuation; 2% eyedrop; Fintal. 2.8 mg/dose nasal spray; Fintal, Cromal AQ.12. TerbutalineUse: Bronchodilator in asthmaDosage: PO: 0.05 mg/kg/dose q 8 hours (max: 5 mg). SC:0.005-0.01 mg/kg/dose; may be repeated in 15-20 minutesfor 3 doses. (max: 0.4 mg/dose). Nebulization: 0.01-0.03mg/kg (Min: 0.1 mg). Inhalation: 1-2 puffs q 6-8 hrs.Brands: 2.5 mg tab; Asmaterb, Bricanyl, Brontaline. 1.5 mg/5 ml Syrup; Bricaline, Bricanyl. 0.5 mg/ml Inj; Bricanyl,Terbutaline Sulphate. 250 mcg/actuation inhaler; 10 mg/ml nebulizing solution; Bricanyl.• May cause tachycardia, flushing, headache, tremor, hypokalemia, dry throat.13. TheophyllineUse: Treatment of reversible airway obstruction due toasthma.Dosage: PO; 6 months to 1year: 12-18 mg/kg/day; 1-9 years:20-25 mg/kg/day; 9-12 years: 15 mg/kg/day; givendivided q 8 hrs.Brands: 400 and 600 mg Tab; Odyphyllin, Phyloday,Theoday. 100 and 200 mg Tab; Theo PA. 250 mg Tab;Codiphylate. 80 mg/15 ml elixir; Broncodril.

16 Pediatric Drug DosesCombinations: Theophylline + Etophylline: 115 + 35 mgand 231 + 69 mg Tab; Cordiophyllin, Deriphyllin retard. 14+ 46.5 mg/5 ml Syrup; Deriphyllin, Theotabllin.Theophylline+Salbutamol: 200 + 4 mg tab; 50 + 1 mg/5 mlSyrup; Theo-asthacare.• May cause tachycardia, hyperactivity, irritability, vomiting, nausea, feeding intolerance, arrhythmias, seizures.14. ZafirlukastUse: Prophylaxis and treatment of chronic asthma.Dosage: 7-11 yrs: 20 mg/day divided q 12h. Administer1 hr before or 2hrs after meals.Brands: 10 and 20 mg Tab; Zuvair.

3 Antiarrhythmics1. AdenosineUse: Treatment of paroxysmal supraventricular tachycardia(PSVT).Dosage: Neonates and Children: Initial dose of 0.05 mg/kgthen increase by 0.05 mg/kg q 2 minutes until a PSVT isterminated or a maximum dose of either 0.25/kg or 12 mgis given.Brands: 3 mg/ml Inj; Adinocor, Adenoject.• Contraindicated in second or third degree A-V block, sick sinus syndrome. Use with caution in asthmatics, patient taking digoxin, verapamil. Always administer by IV site closest to the heart as administration into lower extremities may result in failure of therapy or requirement of higher doses and follow each bolus by saline flush.2. AmiodaroneUse: Life threatening ventricular arrhythmias.Dosage:• PO: < 1yr of age; 600-800 mg/1.73 m2/day divided q 12 h > 1yr; 10-20 mg/kg/day divided q 12 hrs for 10 days, then 5-10 mg/kg/day. Either arrhythmias are controlled or after 1-4 wks of treatment doses are reduced to half.

18 Pediatric Drug Doses• IV: Loading dose of 5 mg/kg over half to one hour; may be repeated upto maximum of 15 mg/kg/day.Brands: 100 and 200 mg tab; 50 mg/ml Inj., Cardarone,Duron, Tachyra.• For IV use dilute to 1.5 mg/ml in D-5%. May cause pro- arrhythmia, nightmares, behavioral changes, hyper- glycemia, pneumonitis, skin color changes.3. Atropine sulphateUse: Preanesthetic medication to inhibit salivation andsecretions, sinus bradycardia, organophosphate poisoning,refraction testing in children, uveitis.Dosage:• Preanesthesia: IV, IM, SC; < 5 kg: 0.02 mg/kg/dose half an hour before then every 4-6 h as needed. > 5 kg: 0.01- 0.02 mg/kg/dose. (Max 0.4 mg/dose)• Sinus bradycardia: Neonates and Children: IV, Intratracheal; 0.02 mg/kg, (Min: 0.1 mg and max: 0.5 mg) may be repeated after 5 minutes once.• Organophosphate poisoning: IV, IM: 0.02-0.05 mg/kg q 10-20 minutes until dry flushed skin, tachycardia, mydriasis, fever is observed then q 1-4 h for at least 24 h.• Bronchospasm in children: Inhalation; 0.03-0.05 mg/kg/ dose 3-4 times/day (max: 2.5 mg/dose)Brands: 0.6 mg/ml Inj., Atropine sulphate, Tropine. 1% dropand ointment; Atro.• Give IV by rapid IV push as slow injection may result in paradoxical bradycardia. For intratracheal use dilute with saline to 2-5 ml then give positive pressure ventilations. Contraindicated in thyrotoxicosis, tachycardia, obstructive disease of GI tract, obstructive uropathy.

Antiarrhythmics 194. DisopyramideUse: Treatment of ventricular arrhythmias and atrialtachyarrhythmias.Dosage: PO: <1 yrs: 10-30 mg/kg/day divided q 6 hrs.1-4 yrs: 10-20 mg/kg/day divided q 6 hrs 4-12 yrs: 10-15mg/kg/day divided q 6 hrs.Brands: 100 mg tab; Regubeat 100 and 150 mg Cap; Norpace.• Contraindicated in IInd and IIIrd degree A-V block, cardiogenic shock, avoid along with erythromycin and clarithromycin. May cause urinary retention, malaise, constipation, hepatic cholestasis, blurred vision, dizziness.5. LidocaineSee under topical analgesic.6. MexiletineUse: Ventricular arrhythmias.Dosage: PO; 1-4 mg/kg/dose q 8 h. Start at lower dosesand increase according to effect.Brands: 50 and 150 mg Cap; 25 mg/ml Inj; Mexitil.• Contraindicated in IInd or IIIrd degree block. May cause bradycardia, hypotension, paresthesias, blurred vision, tinnitus, convulsions.7. PhenytoinSee under antiepileptic.8. ProcainamideUse: Ventricular tachycardia, premature ventricularcontractions, atrial fibrillation and paroxysmal atrialtachycardia.

20 Pediatric Drug DosesDosage:• PO: 15-50 mg/kg/day divided q 3-6 hrs (Max: 4g/day)• IV: Loading dose of 3-6 mg/kg/dose to be given over 5 minutes (Max: 100 mg/dose); may be repeated q 5-10 minutes as needed to maximum of 15 mg/kg. Maintenance dose is 20-80 mcg/kg/minute (max: 2 g/ day).Brands: 250 mg Tab; 100 mg/ml Inj., Pronestyl.• May cause hypotension, arrhythmias, agranulocytosis, neutropenia, hepatomegaly, lupus like syndrome.9. PropranololSee under antihypertensive.10. Quinidine SulfateUse: Supraventricular tachycardia, paroxysmal ventriculartachycardia, ventricular ectopics.Dosage: Test dose is given in 2 mg/kg followed by doseof 30 mg/kg/day divided q 6 hrs. Test dose is givenfor idiosyncratic reaction, intolerance, syncope, throm-bocytopenia.• May cause hypotension, heart block, bone marrow suppression, thrombocytopenia.11. SotalolUse: Supraventricular and ventricular arrhythmias.Dosage: 2-8 mg/kg/day divided q 8-12hrs.Brands: 40 and 80 mg Tab; Sotagard.

4 AntibioticsAMINOGLYCOSIDESDosage adjustment in renal impairment is required.Administer other antibiotics such as penicillins andcephalosporins at least 1 hr. before or after givingaminoglycosides. May cause ototoxicity, nephrotoxicity andneuromuscular blockade.Few indications for serum concentration monitoringinclude:• Treatment duration > 5 days.• Patients with impaired renal functions.• Infants < 3 month of age.• Signs of nephrotoxicity and ototoxicity.• Use of other nephrotoxic agents.1. AmikacinUse: Active against gm-ve bacilli, especially E. coli, Klebsiella,Proteus, Enterobacter, Serratia, Pseudomonas, MycobacteriumTB and Atypical mycobacteria.Dosages: IV/IM:Neonates: PNA < 7d: 1200-2000 g : 7.5 mg/kg q 18-24 hrly; > 2000 g : 10 mg/kg q 12 hrly. PNA > 7d: 1200-2000 g : 7.5 mg/kg q 12-18 hrly; > 2000 g : 10 mg/kg q 12 hrly.

22 Pediatric Drug DosesInfants and children: 15-20 mg/kg/day divided q 8-12 hrly.Antitubercular dose : 15-30 mg/kg/day (Max. dose: 1g)Brand: 100, 250, 500 mg/ 2 ml Vial; Amicin, Amikef, Amitexetc.Administration: Administer IV slowly over 30 to 60 min;dilution should be 10 mg/ml.2. Gentamicin SulfateUse: Active against gram negative bacilli, specially E coli,Klebsiella, Proteus, Enterobacter, Serratia, Pseudomonas andgram positive Staphylococcus.Dosages: IV /IM:Neonates: PNA < 7d: 1200-2000 g : 2.5 mg/kg q 12-18 hrly; > 2000 g : 2.5 mg/kg q 12 hrly; PNA > 7d: 1200-2000 g : 2.5 mg/kg q 8-12 hrly; > 2000 g : 2.5 mg/kg q 8 hrly;Infants and children : 2.5 mg/kg/dose q 8 hrly. Intrathecal : Preservative free preparation for intraventricular or intrathecal use. Neonates; 1 mg/24 hrly. Children; 1-2 mg /24 hrly.Topical solution: Instill 1-2 drop every 2-4 hrly, upto 2 drops/hr for severe infections.Brand: 20, 40, 80 mg/vial; Garamycin, Genticyn, Bro-garacin etc.Topical: Genticyn and Garamycin eye/ear drop 0.3%Combinations: Gentamicin + Hydrocortisone- E/E drop.

Antibiotics 23Gentamicin + Clotrimazole + Beclomethasone + lignocaine- Ear drop.Gentamicin + Dexamethasone- E/E drop.Gentamicin + Beclomethasone - E/E drop.Administration: Final concentration for IV should notexceed 10 mg/ml.3. Kanamycin SulfateUse: Active against Shigella, Klebsiella, E. coli, Serratia, Proteusetc. Used as anti-mycobacterial along with other agents.Dosages: IV/IM: 15 mg / kg/day divided 12 hrly.Antitubercular: 15-30 mg/kg/day [Max. dose: 1 g]Brand: 1 g / Vial; Kanamycin and Kancin.4. NeomycinUse: PO before surgery to decrease GI flora and forhyperammonemia, to treat diarrhea; used topically forminor skin infections.Dosages: PO: Infants: 50 mg/kg/day divided q 6 hrly.Children: 50-100 mg/kg/day divided q 6-8 hrly.Preoperative bowel antisepsis: 90 mg/kg/day divided 4hrly for 2 day. Hepatic Coma: 2.5-7g/m2/day divided every4-6 hrly for 5 to 6 day, not to exceed 12 g/day.Topical: Apply oint. 1-3 times/day.Brand: Cap. 350 mg. Neomycin Sulphate.Combinations: Neomycin + Polymyxin-B-Eye drops. Neomycin + Betamethasone-E/E drops. Neomycin + Dexamethasone-E/E drops. Neomycin + Hydrocortisone-Ear drops.

24 Pediatric Drug Doses5. Netilmicin SulfateDosages: IV/IM:Newborns: <1200 g, 0-4 wk : 2.5 mg/kg q 18-24 hrly. 1200-2000 g, 0-7 days : 2.5 mg/kg q 12-18 hrly; 1200-2000 g, > 7 days : 2.5 mg / kg q 8-12 hrly. > 2000 g, 0-7 days : 2.5 mg /kg q 12 hrly; > 2000 g, > 7 days : 2.5 mg/kg q 8 hrly;Infants: 7.5-10 mg/kg/day/divided 8-12 hrly.Brand: 10, 25, 50, 100, 200, 300 mg/Vial; Netilmicin andNetromycin.6. StreptomycinUse: Used in combination therapy of active TB; and incombination with other agents for treatment of streptococcalor enterococcal endocarditisDosages: IMNeonates: 10 to 20 mg/ kg /day.Children: 20 to 40 mg/kg /day divided 12 hrly or singledose; not to exceed 1 g /day.Brands: 0.75 g, 1 g /Vial; Ambistryn-S.Administration: Select large muscle for IM; concentrationnot to exceed 500 mg/ml; rotate injection sites.7. TobramycinUse: Active against gram negative bacilli, specially E. coli,Enterobacter, Klebsiella, Serratia, Proteus and Pseudomonas;ophthalmic infections.Dosages: IV/IM:

Antibiotics 25Neonates: PNA < 7 days: 1200-2000 g: 2.5 mg/kg q 12-18 hrs; > 2000 g: 2.5 mg/kg q 12 hrly. PNA > 7 days : 1200-2000 g: 2.5 mg./kg q 8-12 hrs; > 2000 g: 2.5 mg/kg q 8 hrs;Children: 5 to 7.5 mg/kg/day.0.3% Ophthalmic solution: 1-2 drops every 1 to 4 hrdepending upon severity of infection.0.3% Ophthalmic ointment: Apply 0.5\" ribbon 2-3 times/day.Brands: 20, 60, 80 mg/Vial; Tobacin, Tobasafe, Tocin.Combinations: Tobramycin + Benzalkonium. E/E drops. Tobramycin + Dexamethasone. E/E drops.Administration: Final concentration should not exceed 10mg/ml.

26 Pediatric Drug DosesCARBAPENEM1. ImipenemUse: Active against gram positive cocci and gram negativebacilli including P. aeruginosa and anaerobes.Dosage: Neonates: IV, IM:PNA ≤ 7 days: < 1200 g : 20 mg/kg divided q 18-24 hrly. > 1200 g : 40 mg/kg/day divided q 12 hrly.PNA > 7 days: 1200-2000 g : 40 mg/kg/day divided q 12 hrly. > 2000 gm : 60 mg/kg/day divided q 12 hrly.Children: 60-100 mg/kg/day divided q 6-8 hrly.Brands: 500 mg, 1000 mg and 1500 mg Inj; Primaxin(equivalent to 250, 500 and 750 mg respectively)Administration: IV: Final concentration should not exceed5 mg/ml.• Seizures may occur when used in patients with CNS infection. Pseudomembranous colitis may occur.2. MeropenemUse: Active against gram positive and gram negativeaerobic and anaerobic pathogens including S aureus,S pneumoniae, H influenzae, N meningitidis, E coli, Klebsiellaetc.Dosage: Neonates: IV: PNA 0-7 days: 20 mg / kg/ dose q 12 hrs. PNA > 7 days: 20 mg/ kg / dose q 8-12 hrs.

Antibiotics 27Children: 60 mg / kg/ day divided q 8 h; meningitis: 120mg/ kg / day divided q 8 h (Max: 6 g/day)Brands: 500 mg and 1000 mg Inj; Meronem and Ronem.Administration: Concentrations should not exceed 50 mg/ml.

28 Pediatric Drug DosesCEPHALOSPORINSActive against both gram negative and gram positive, butas we move to higher generation, activity against gramnegative goes on decreasing. Probenecid may decrease theirrenal tubular secretion and increases serum concentration.Third generation are highly resistant to β-lactamase.1. CefadroxilUse: Streptococcal pharyngitis, tonsillitis; SSTI caused bystreptococci or staphylococci, UTI caused by Klebsiella, E coliand Proteus mirabilis.Dosage: 30 mg/kg/day divided q 12 hr PO (Max. 2 g/day).Brand: 500 mg Cap; 125, 250, 500 mg Tab; 125 mg/5 mlSusp; Bludrox, Cefadrox, Cefadur, Droxyl etc.Combinations: Cefadroxil + Ambroxol, Cefadroxil +Probenecid, Cefadroxil + LAB.2. CefazolinUse: Treatment of RT, SSTI, UTI, Biliary tract, bone and jointinfections; and septicemia due to susceptible gram positivecocci (except enterococcus), preoperative prophylaxis;bacterial endocarditis prophylaxis for dental and upperrespiratory tract procedure.Dosage: IV/IM:Neonates:PNA < 7 days : 40 mg/kg/day divided q 12 hrs.PNA > 7 days : < 2000 g: 40 mg/kg/day divided q 12 hrs. > 2000g : 60 mg/kg/day divided q 8 hrs.Infants and children: 50-100 mg/kg/day divided q 8 hrs(Max: 6 g/day).

Antibiotics 29Bacterial endocarditis prophylaxis for dental and upperrespiratory procedures in penicillin allergic patients: 25 mg/kg 30 minutes before procedure (Max: 1g).Brand: 250, 500, 1000 mg/vial; Cezolin, Orizolin, Reflin.3. CefaclorUse: Staph aureus, S pneumoniae, H influenzae; treatment ofotitis media, sinusitis and SSTI, bone and joint infections;UTI caused by E coli, Klebsiella and Proteus.Dosage: 20-40 mg/kg/day divided q 8-12 hrs. PO (Max:2 g). Twice daily option is for otitis media and pharyngitis.Brand: 250, 500 mg Cap; 125, 250 mg Tab; 125 mg/5ml Syp;Distaclor, keflor.4. CefuroximeUse: Staphylococci, Group B Streptococci, Pneumococci, H.influenzae (type A and B), E coli, Enterobacter and Klebsiella;treatment of URTI and LRTI, Otitis media, acute bacterialsinusitis, UTI, SSTI, bone and joint infection and sepsis.Dosage: IV/IM: Neonates: 40-100 mg/kg/day divided q12 hrs. Children: 200-240 mg/kg/day divided q 8 hrs.PO: Infants and Children; Pharyngitis, tonsillitis: 20-30 mg/kg/day divided q 8 hrs (Max: 500 mg/day). Acute otitismedia, acute bacterial sinusitis, impetigo: 30 mg/kg/daydivided q 8 hrs (max: 1 g/day).Adolescents: Uncomplicated UTI: 125-250 mg q 12 hrs. Uncomplicated gonorrhoea: Single 1 g dose.Brand: 125, 250, 500 mg Tab; 125 mg/ 5 ml Susp; 250, 750mg/vial. Altacef, Cetil, Zocef etc.Combination: Cefuroxime + Probenecid.

30 Pediatric Drug DosesAdministration: > 30 mg/ml for IV and should beadministered over 15-30 minutes. For intravenous pushadminister over 3-5 minutes at a maximum concentrationof 100 mg/ml.5. CefotaximeUse: LRTI, SSTI, Bone and joint, Intra-abdominal andgenitourinary tract infections; Meningitis due to susceptibleorganisms such as H. influenzae and N. meningitidis; Neisseriagonorrhoea etc.Dosage: IM/IVNeonates: < 1200 g: 100 mg/kg/day divided q 12 hrs. 1200-2000 g: 100-150 mg/kg/day divided q 8-12 hrs.Infants and Children 1 month to 12 yrs: < 50 kg: 100-200 mg/kg/day divided q 6-8 hrs. Meningitis: 200 mg/kg/day divided q 6 hrs. > 50 kg: Moderate to severe infection: 1-2 g q 6-8 hrs; life threatening infection: 2g/dose q 4 hrs; (Max. dose: 12 g/day)Brand: 125, 250, 500, 1000 mg / Vial; C-Tax, Omnicef, Taxim,Udicef.Combination: Cefotaxime + Sulbactam.Administrations: In a concentration ranging from 20-100mg/ml over a period of 5-30 min. For IM 250 mg/ml.6. CeftriaxoneUse: Treatment of sepsis, meningitis, LRTI, SSTI, bone andjoint, intrabdominal and UTI. Active against H influenzae,Neisseria, and Enterobacteriaceae; gonococcal infection orchancroid; periorbital or buccal cellulitis, salmonellosis or

Antibiotics 31shigellosis, pneumonia of unestablished etiology (< 5 yrsof age), otitis media etc.Dosage: IM/IVNeonates: < 2000 g: 50 mg/kg/day q 24 hrs. > 2000 g: 50 to 75 mg/kg/day q 24 hrs.Gonococcal infection: 25-50 mg/kg/day q 24 hrs for 7 days.Infants and children: 50-75 mg /kg/day divided q 12-24hrs.Meningitis : 80-100 mg/kg/day divided q 12-24 hrs; loadingdose of 75 mg/kg may be administered at the start oftherapy; (Max. dose: 4 g/day.)Chancroid: IM, 50 mg/kg as a single dose (Max. dose: 250mg)Acute epididymitis: IM, 250 mg in a single dose.Acute otitis media: 50 mg/kg in a single dose (Max. 1 gm)Brand: 125, 250, 500, 1000 g/Vial; C-Tri, Cefaxone, Monocef.Combinations: Ceftriaxone + Sulbactam.Administration: Use Cefotaxime in place of ceftriaxone inhyperbilirubinemic neonates. IV push over 2-4 minutes ata maximum concentration of 40 mg/ml. For IM 250 mg/ml.7. CefoperazoneUse: RTI, SSTI, UTI and Sepsis. Active against E coli,Klebsiella and Haemophilus but variable activity againstStreptococcus and Staphylococcus species.Dosage: IV/IM: Neonates: 100 mg/kg/day divided q 12hr. Children: 100-150 mg/kg/day divided q 12 hrs (Max:12 g/day).

32 Pediatric Drug DosesBrand: 250, 500, 1000 mg/Vial; Magnamycin, Myticef.Combinations: Cefoperazone + Sulbactam.Administration: For IM > 250 mg/ml and IV 5-50 mg/mlover 30 mins.• Concomitant use of anticoagulants may increase the risk of severe hemorrhage. Cefoperazone may decrease vitamin k synthesis by suppressing GI flora and Vitamin 'K' deficiency may occur.8. CeftazidimeUse: RTI, UTI, SSTI, intra-abdominal, osteomyelitis, sepsisand meningitis caused by Enterobacteriaceae andPseudomonas; empirical therapy for febrile, agranulo-cytopenic patients.Dosage: IM/IV.Neonates: 1200 - 2000 g: 100 mg/kg/day divided q 12 hrs. > 2000 gm: 150 mg/kg/day divided q 8 hrs.Infants and Children: 100-150 mg/kg/day divided q 8 hrs.Meningitis: 150 mg/kg/day divided q 8 hrs; (max: 6 g/day).Brand: 250, 500, 1000 mg/Vial; C-zid, Tizime, Zidime.Administration: For IM > 300 mg/ml and for IV 40-180 mg/ml.9. CefdinirUse: Respiratory tract, SSTI, and OM; susceptible organismsare S pneumoniae, H influenzae, M catarrhalis and S aureusetc.Dosage: PO > 6 months – 12 yrs: 14 mg/kg/day divided q12 hrs for 5-10 days in OM, pharyngitis/tonsillitis, SSTI,acute maxillary sinusitis (Max: 600 mg/day).

Antibiotics 33Brands: 125 mg Tab; 300 mg Cap; 125 mg/5 ml Susp;Aldinir, Rtist, Sefdin.• Administer with food, administer at least 2 hrs before or after antacids or iron supplements (as they decrease absorption by 40 and 80% respectively)10. CefepimeUse: LRTI, SSTI, UTI by various gram positive and gramnegative organisms.Dosage: IV/IM: 100-150 mg/kg/day divided q 8-12 hrs.Brands: 500 mg, 1 and 2 gm/Vial; Cepime, kefage,Novapime.Administration: 40-100 mg/ml for IV and 300 mg/ml forIM.• Not compatible with metronidazole, vancomycin, aminoglycosides and aminophylline.11. CefiximeUse: UTI, OM, RTI; Susceptible organisms are Streptococcus,H influenzae, M catarrhalis, N gonorrhoea etc.Dosage: PO: 8 mg/kg/day divided q 12 hrs (Max: 400 mg/day). Enteric fever: 20 mg/kg/day q 12 hrs for 7 days.Shigellosis: 8 mg/kg /day q 12 hrs for 5 days. UTI: 16 mg/kg/ day q 12 hrs on day 1, then 8 mg/kg/day for 13 days.Brands: 50, 100, 200 mg Tab; 50 mg/5 ml Susp; Cefi, Extacef,Fixx.• Cefixime may increase warfarin (increase PT) and carbamazepine levels.